| NPI | 1316986904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 230051) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MA 230051) |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: MA 230051) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2022-02-16 |